ArticleGynecologic and obstetric investigation2025
Clinical Characteristics of Women with Surgical Signs of Superficial Peritoneal Endometriosis but a Negative Histology: A Nested Case-Control Study.
Article in Gynecologic and obstetric investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe aim of this study was to investigate the clinical characteristics of women with superficial peritoneal endometriosis (SUP) diagnosed by surgery and not confirmed by histology, compared with histologically proven SUP.
designThis was a single-center, nested case-control study. Participants/Materials: Patients with a surgical report of SUP (n = 390), comprising a subgroup with histological confirmation of endometriosis (n = 245) and a subgroup without it (n = 145). In addition, we enrolled a control group (n = 390) among nonpregnant patients submitted to a laparoscopy or laparotomy for a benign gynecologic condition without any macroscopic sign of endometriosis.
settingThe review was conducted in the University hospital.
methodsData synthesis, descriptive statistics, chi-square test, and one-way analysis of variance followed by Tukey's test.
resultsAll groups had similar age, body mass index, smoking prevalence, serum anti-müllerian hormone levels and menstrual cycle patterns. However, the two SUP subgroups had the same prevalence and intensity of endometriosis symptoms. The SUP/histology-negative subgroup was more likely to have a familial history of endometriosis (14% vs. 1%) or a personal history of primary infertility (29% vs. 19%) or primary dysmenorrhea (50% vs. 33%) compared to the control group (all p <0.01). The intensity scores for dysmenorrhea, deep dyspareunia, and non-cyclic chronic pelvic pain were severer in both SUP subgroups than in the control group (p < 0.05). LIMITATIONS: The participants underwent surgery, so their symptoms may not represent groups with initial or mild disease that responded to medical treatments. Due to the retrospective design, performance bias cannot be ruled out.
conclusionsPatients with suspected SUP lesions and a negative histology had clinical characteristics resembling those with proven endometriosis. Further characterization with molecular biomarkers is needed to explain why these women are so symptomatic in the absence of histological hallmarks of the disease.
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